Welcome back to our new regular feature, Leadlines, a collection of articles from multiple sources highlighting topics that are relevant to The Floating Hospital’s mission. We hope it will provide a fuller understanding of the issues that drive our work each day.

This month’s article selection reflects changes in health policy on a federal level and the challenges our patients face locally regarding poverty trends, homelessness and other socio-economic issues. The city’s mayoral race is also pushing some of these topics to the forefront of news coverage.

Covid vaccine access

The recent decision by the federal Department of Health and Human Services to rescind the recommendation that pregnant women and children receive the annual Covid-19 shot has created confusion and some barriers to pregnant women whose doctors have recommended they be immunized.

According to CNN, there have been reports of patients turned away from pharmacies when they attempted to be vaccinated. A group of 30 health and medical organizations are now advocating for insurance coverage and access to these vaccines. Insurers use information from the C.D.C. and federal government health advisors to decide what health services and medications they will cover.

The New York Times noted that “About 38 million children are covered by the Vaccines for Children program for low-income families,” which we participate in. In an article from May 27, it stated that “the impact of the decision is unclear on that program, though the health secretary has broad authority over contracting with vaccine makers for the shots purchased by federal officials.” Dr. Sean O’Leary, a pediatric vaccine expert for the American Academy of Pediatrics, told The Times in a statement that “the decision could strip families of choice.” Medicare and Medicaid are now unlikely to cover the cost of Covid vaccination.

And just in time for summer, a new Covid strain could mean a new outbreak. The variant NB.1.8.1 has been detected in international travelers coming through some major U.S. airports. The symptoms from this variant are similar to recent Covid strains: fever or chills, cough, sore throat, congestion, fatigue, difficulty breathing and diarrhea. It does not appear to cause more severe symptoms than previous iterations, but it is spreading fast in the countries in which it is active.

Poverty on their minds

We see poverty’s effects every day in our clinics and work to relieve them by supplying urgent needs such as food, personal care products, baby items and clothing, as well as offering ways to break the cycle over the long term so families can move forward and thrive. So it’s heartening to see when others are addressing, speaking or writing about it.

At a recent Fortune magazine conference in Riyadh, Jacqueline Novogratz, the founder and CEO of Acumen, said a Silicon Valley model of entrepreneurship won’t cure poverty. Her company has invested $260 million in a large range of organizations that provide affordable education, health care, clean water, energy and sanitation across the globe. At 25, she left a job as a Wall Street analyst to work for the World Bank and UNICEF in Africa and helped create the first microfinance institution in Rwanda. Although she applauds the good intentions of those who want to fund projects from the comfort of their homes and offices, she said, “If you haven’t immersed, gotten close and understood the problem from the perspective of the people that you are there to serve, game over.”

Others are advocating for the child tax credit to be expanded and made permanent to end child poverty. In her op-ed for the Mercury News, the United Way Bay Area CEO Keisha Browder said the temporary expansion in 2021 to $3,000 per child and $3,600 for children under six with no minimum income requirement made the credit “America’s most effective anti-poverty program.” In tracking the spending of this extra income, it was found that parents spent the money on food, clothing and rent. “For many children, it was the first time they experienced a pantry filled with food, shoes that fit, or maybe even a new blanket. Not only were parents able to meet their children’s immediate, basic needs, these purchases stimulated local economies.” It reduced child poverty by 46% and when the program expired at the end of that year “these gains reversed almost overnight.”

Although it did not attract the attention of local news outlets here, Period Poverty Week, which was May 12-18 this year, did receive coverage from regional news organizations across the country as well as state and local representatives, such as New York State Senator Roxanne J. Persaud. Since 2018, the Alliance for Period Supplies, which is part of the National Diaper Bank Network, has been supporting programs that collect, warehouse and distribute menstrual supplies in communities where there is need. A 2021 study found that “over one-third (38%) of low-income women report missing work, school or similar events due to lack of access to period supplies” and that period poverty has a disproportionate effect on Black and Latina women.

Homelessness

Against the backdrop of these issues of poverty, it’s not surprising to learn that more New Yorkers are entering city homeless shelters.

On June 16, the New York City Council’s public housing committee held a hearing to find out why there are some 8,600 vacant NYC Housing Authority apartments in the midst of an affordable housing crisis and why those apartments are taking more than a year to fill.

Some educators are concerned that students experiencing homelessness will soon lose protections that previously ensured they could stay in their school, even when their temporary housing is outside of the district where they originally enrolled. A federal law, the McKinney-Vento Homeless Assistance Act, offers both legal protections and a grant program to support students in this situation. It is administered by the federal Department of Education, which may close soon. This has raised fears among advocates that the law’s protections will also cease, causing a return to a time where “children languished in shelters, they languished on couches and cars, because they weren’t actually in school.”

What’s up with bird flu?

Bird flu hasn’t been the subject of major headlines recently, but bubbling beneath the surface are some developments of concern. The federal government announced on May 28 that it was withdrawing a $766 million contract intended to support the development of a bird flu mRNA vaccine. Moderna, which is developing the vaccine, announced it will “explore alternative paths forward for the program.” By withdrawing from the contract, the United States is also forfeiting the right to purchase these vaccines to build a pre-pandemic national reserve. There are other, more traditional ways of formulating flu vaccines aside from the mRNA technology, but an expert in pandemics noted it’s a slower process and some need eggs—which could be in short supply at that point—to develop.

Even Food and Wine magazine is following the situation, noting that the federal government has stopped bird flu monitoring and testing the milk supply. Some states and localities are continuing their own efforts, but the CEO of a national alliance of public health clinicians noted that “Most local and state health data are funneled to federal agencies for broader analysis and response coordination. As that pipeline weakens, the insights available to the public become less timely, less accurate, and far less actionable.”

And bird flu is proving to be very deadly to cats, which are also contracting it in new ways. A recent study by the University of Maryland School of Public Health found cats are getting bird flu more often and this could have serious consequences for eventual human-to-human infection.